LGBTQIA+ Affirming Therapy in Montgomery County, MD

There are 3 important steps to living a mentally healthy life as a LGBTQIA+ person in Montgomery County, MD.

1. Be Who You Are. LGBTQIA+ Affirming Therapy Empowers You to Define Your Identity for Yourself.

You know yourself best. It can be hard to hang onto that knowledge in the face of others’ opinions. Accidentally internalizing someone else’s values can lead to conflict within yourself (such as internalized homophobia, biphobia, transphobia). Therapy is a space for you to explore who you are, and grow into the person you want to be.

2. Love Who You Love. LGBTQIA+ affirming counseling can help you love each other well.

Love is a beautiful thing. Loving another person isn’t easy though. We all need to learn how to set boundaries, resolve conflict, and make repairs in relationships. Families are important places to learn these skills. Let us help you grow and heal your family relationships, and your partner relationships too.

Young person with bright makeup holding a puppy, smiling, looking to the side

3. Parent Who You Have. An expert LGBTQIA+ affirming therapist can help you meet your child where they are.

Your child will lead you to unexpected places. As a parent, you learn that pretty quickly. Learn to navigate your child’s identity journey with the support of an LGBTQIA+ affirming therapist. We’ll help you keep your relationship strong as your child grows into an adult.

This is especially important for your child. Studies show that risk of suicide is greatly reduced when children feel supported by their parents. And children do not automatically feel supported. Mutual understanding takes work, and we’re here for it. 

What is LGBTQ Affirming Therapy?

You may see it written as LGBTQIA+ affirming, LGBTQ affirming, queer affirming, LBGTQIA2S+ affirming, or gender affirming care. All of these mean that a licensed therapist is helping you with your stress and other challenges, without trying to change who you are.

What is an LGBTQ affirming provider?

An LGBTQ affirming provider is someone who supports your process of identifying your own gender and sexuality in the terms and time frame that work for you.

Our LGBTQIA+ affirming therapists believe that you know yourself best, and have the right to choose how and when you describe yourself to others. Your way of identifying yourself is valid, no matter what someone else may think.

There is no license or certification specific to LGBTQIA+ affirming therapy, but there are many strong training programs that teach therapists to closely examine their work and establish affirmative practices. The University of Maryland’s Sexuality and Gender Diversity Learning Community is one such program. Our Director holds a certificate from this program. In addition our team of therapists has participated in the LGBTQIA+ Affirmative Care Summit, and the recordings of this training are provided each time we hire a new therapist.

We continually seek to improve our affirmative practices. If there is something you think we should do differently, let us know!


What are the benefits of affirmative therapy?

Working with a LGBTQIA+ provider who is knowledgeable and affirming can provide the sense of connectedness, belonging, support and acceptance that you may not receive from your family or community.* As family therapists, we can also help your family members to understand where you’re coming from (if you choose).

In addition, good mental health care can help reduce the impact of abuse or other forms of victimization you experience. In therapy you’ll learn coping strategies and work on strengthening your overall mental health.


Why is LGBTQIA+ affirming therapy important?

Affirmative care is the necessary foundation for any healthcare you receive. An affirming provider can help you feel safe to share your thoughts, feelings, and experiences so that the care you receive can truly match your needs. It’s also important to find a therapist who is competent in understanding the needs of LGBTQIA+ people and skilled at providing the kind of therapy you want or need (Art Therapy, CBT, ACT, trauma informed care, etc.).

You may have heard the heartbreaking statistics about the higher rates of suicide among LGBTQIA+ people. Many studies have been done to determine factors that can prevent suicide for this population. These are called “protective factors.” A 2019 review of all research on this topic identified supportive relationships with a mental health practitioner as a key protective factor for LGBTQI+ people ages 10-24, but ONLY if the provider is knowledgeable and affirming.*


What are the goals of affirmative therapy?

The goals of affirmative therapy are what you want them to be. Your provider should be asking you what you want to achieve, and telling you what it takes to get there. The goals will be personal to you.

However, there are some general values that would apply to affirmative therapy. Your therapist will strive to strengthen the parts of your life that support good mental health This includes mutually supportive relationships with others, sleep, safe practices (in your sex life and elsewhere), good emotion regulation, self awareness, a sense of purpose, and clear boundaries.

What kinds of therapy are not LGBTQ affirming?

If someone else is setting the goals for you, this may not be affirmative therapy. For example, if your parent wants you to blend in more at family gatherings or keep your identity to yourself, that should NOT be a therapy goal. Your therapy goal in that situation might be “I’ll start advocating for myself in conversations with my mother” or “I’ll set boundaries with family in order to support my mental health.”

Conversion therapy is an extreme example of non-affirmative therapy, in which a parent or authority figure determines that your identity is wrong and engages in practices to force you to change. Conversion therapy is not just ineffective. It is considered abuse by most major mental health professions.


What does LGBTQIA+ affirming therapy look like?

LGBTQIA+ affirming therapy starts with the therapist asking you how you identify and how you’d like them to refer to you.  Your therapist will listen, and will call you by your preferred name and pronouns. We will also ask you how you prefer to refer yourself in different contexts (for example in a family session vs. an individual session, or on paperwork that you’ll submit to insurance). 

Therapist with short grey hair sitting, listening intently and taking notes.

The therapist will ask you what brought you to therapy. This usually includes talking about some things that are hard for you or cause you stress.  You should ALWAYS go at your own pace when talking about these things. Your therapist will learn more about you as you get comfortable and start to share more. There’s no need to rush.

As you are talking the therapist might notice some of your strengths. The therapist will point out those strengths (such as “it took a lot of determination to keep going after all those obstacles”).

They will ask if you feel safe at home and in your community, and take steps to try to make you safer if you do not. You should also expect your therapist to ask you if you are thinking of hurting yourself or someone else. These are standard questions that they ask everyone in a first session.

Your therapist will also ask you some diagnostic questions about your mental health. These help the therapist understand how you think and feel. If you have a specific diagnosis (such as ADHD), share that information.

Finally, the therapist will ask you what you want to achieve (your goal or goals).  Examples of goals might be improving relationships, healing from past trauma, doing better in work or school, feeling better about yourself, helping others understand you better, or having less anxiety.

You and the therapist will make a plan together to help you reach your goals.  That might involve setting boundaries, communicating differently, or simply feeling more at home in your own skin.


What is the best therapy approach for LGBTQ people?

Good therapy for LGBTQ+ people is provided by an expert LGBTQIA+ affirming therapist

LGBTQIA+ affirming therapy is a strengths-based approach.  This means your therapist pays attention to and values your identity and your priorities. Your therapist should never pressure you to come out or to identify yourself in a particular way.

Your therapist should have knowledge of the common stressors LGBTQ people face, without assuming that those are your stressors in particular. Once they’ve gotten to know you, your therapist should understand your values and what you want to accomplish in therapy.  And help you get there. He/she/they may help you figure out what’s getting in your way, or help you build skills to cope with the stress you experience.

LGBTQ+ affirming care can be in person or online

The decision to attend therapy is personal. You may feel more comfortable seeing your therapist in the office, or online from another private space. Your therapist should encourage you to do what works for you.  They may have some ideas about how to get yourself and your space ready for therapy if you choose the online option. This is to help create the opening up and closing down processes that naturally occur when you enter and leave a therapy space. If being in your own space feels best to you, your therapist can help you make your own space work for online therapy.

Includes evidence-based practices

Trauma informed care is an important component of all types of therapy for LGBTQ folx. Once you know you have an affirmative therapist, a trauma informed therapist, and a safe space, the type of therapy you receive will depend on what you want to achieve. 

Cognitive Behavioral Therapy (CBT) might help you slow down racing or repetitive thoughts.  Mindfulness-based approaches can be good for reducing anxiety, but can also be tough for neurospicy people.  If you have ADHD or are autistic, your therapist should be able to find the tools that work better for you. 

Psychoeducational therapy can help you to identify common stressors and patterns that might be affecting you. A therapist with expertise in the LGBTQIA+ experience might teach you about internalized homophobia, transphobia, or biphobia in this type of treatment.

Two dads sitting on a bed with their child.  One is hugging the child and the other is showing her something.

Art therapy and play therapy (at any age!) can help you discover another side of yourself and process painful experiences.  If you find yourself feeling upset most of the time, or get very upset very easily, Dialectical Behavior Therapy (DBT) can help with emotion regulation. Family therapy can help heal relationships.


Other frequently asked questions about LGBTQIA+ affirming therapy in Montgomery County, MD

  • Affirmative counseling is characterized more by what the counselor doesn’t do than what they do. Counselors are people. And when they’re uncomfortable or unfamiliar with something, it shows. A counselor who doesn’t have expertise in LGBTQ affirming care might persistently misgender you, try to rush your coming out process, or side with your family members in arguments about your identity.

    An LGBTQ affirmative counselor takes your sexuality and gender identity as fact, and respects your right to self-identify. They focus on what you want to work on in therapy. Your identity is NOT a problem to be solved.

    Affirmative counselors also understand the common stressors LGBTQ people face. They can empathize with the agony of gender dysphoria and understand that puberty might be triggering for you. They support your efforts to find the care you need to truly be yourself. And they work to help your relationships thrive.

  • Affirmative therapy validates (affirms) your ideas about your own identity and your vision for your life. This is especially important when you identify as LGBTQIA+ because family members, faith leaders, and others may try to teach you to change your sexuality or gender identity.

    Rejection by people in your family or community is associated with increased risk of suicide for LGBTQ youth and young adults. Affirmative care can mitigate this risk. It isn't just helpful. It's life saving.

  • Affirmative care is more of an ethical standard than an approach to treatment. All major professional associations for counselors and therapists in the United States agree that affirmative care is the standard of care for LGBTQIA+ children, teens, adults, and families. This is true because studies consistently show that treating someone's sexuality or gender identity as a problem to be solved damages the mental health of that person. As counselors and therapists, we are responsible for supporting and improving mental health, and that means we're responsible for ensuring that we can provide affirmative care.

Are you ready to meet your best self? Start by meeting our Expert LGBTQIA+ Affirming Therapists, in our Montgomery County, MD office or online.

If you’re ready to explore how LGBTQIA+-affirming therapy can support your identity journey, we’re here to help! Reach out to discover how we can work together to achieve your goals. Whether you’re looking for personalized support, practical strategies, or simply someone to talk to, we’re dedicated to making sure you and your family feel understood and empowered. Follow the steps below to start your path toward a more fulfilling and balanced life.

  1. Reach out to us here so we can get to know your story better.

  2. Learn more about our approach at Better Together Family Therapy.

  3. Get started with a LGBTQIA+ affirming therapist and reach your goals.

Other Services We Offer in the Bethesda, MD Area

At Better Together Family Therapy, we’re committed to providing LBGTQIA+ affirming care for people of all ages. Identity development is a lifelong journey, and you deserve to be appreciated for who you are at every stage.

Tween and teen therapy is designed to help young people navigate the specific challenges of adolescence with confidence and resilience. Family therapy is a vital source of support for parents and kids who are striving to communicate clearly, set boundaries, and enjoy life together. Sessions foster healthy dynamics and communication within your family, ensuring that everyone’s needs are heard and respected. Couples therapy and marriage counseling can strengthen intimacy and mutual understanding between partners in any type of committed relationship (open relationships, poly relationships, and any arrangement that works for you).

And of course, treatment for our LGBTQ+ clients isn’t just focused on identity. Therapy serves to support you in facing the challenges of everyday life, coping with anxiety, and living well with neurodivergence. Read more about our services for adults, children, and families here. These include specialized SPACE treatment for families with anxious children, play therapy, art therapy, and more. Reach out and get ready to thrive!